Jennifer Rebecca Mellick, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

04-30373 Issued in KS

Practice address

7301 W 133Rd St
Suite 102
Overland Park, KS 66213-4750

Phone

(913) 888-4567

Fax

(913) 888-1277

NPI assigned

Jul 7, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jmellick755685@direct.kuha.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Children'S Mercy - Pediatric Partners, Inc

  • Pediatrics Physician
  • Overland Park, KS
  • NPI 1245989789
  NPD (past)
• Shawnee Mission Medical Center Inc

  • General Acute Care Hospital
  • Merriam, KS
  • NPI 1023171634
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1093712903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7301 W 133RD ST",
            "address_2": "SUITE 102",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662134750",
            "telephone_number": "913-888-4567",
            "fax_number": "913-888-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 W 133RD ST",
            "address_2": "SUITE 102",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662134750",
            "telephone_number": "913-888-4567",
            "fax_number": "913-888-1277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLICK",
        "first_name": "JENNIFER",
        "middle_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "KS",
            "license": "04-30373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSKC PROVIDER NUMBER",
            "identifier": "33978014",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Michelle Meirink, FNP
• Adam Meisinger, PHARMD
• Beselot Mekonnen
• Katherine Marie Melcher, PHARMD
• Melissa Frye
• Ashley Dawn Melton
• Brook Aileen Melvin
• Jay L. Memmott, LCSW
• Svetlana Mena, D.C.
• Christina Marie Mendenhall, CRNA

• Pediatric Adolescent Medicine Physician in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Pediatric Adolescent Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.